Cordial v. Ernst & Young

483 S.E.2d 248, 199 W. Va. 119, 1996 W. Va. LEXIS 234
CourtWest Virginia Supreme Court
DecidedDecember 13, 1996
Docket23088
StatusPublished
Cited by39 cases

This text of 483 S.E.2d 248 (Cordial v. Ernst & Young) is published on Counsel Stack Legal Research, covering West Virginia Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cordial v. Ernst & Young, 483 S.E.2d 248, 199 W. Va. 119, 1996 W. Va. LEXIS 234 (W. Va. 1996).

Opinion

ALBRIGHT, Justice.

Appellant and plaintiff below, Betty Cordial, Deputy Receiver of Blue Cross and Blue Shield of West Virginia, appeals 1 a jury verdict entered in favor of Ernst & Young in an action for fraud, breach of contract, and negligent misrepresentation. We originally granted this appeal on the sole issue of whether the circuit court erred in giving Defendant’s Instruction No. 73. Ms. Cordial complains that the instruction incorrectly stated the law as it related to the independent investigation exception to fraud. After briefs and oral argument, this Court broadened its grant of appeal to include all issues and requested supplemental briefs. We find reversible error, and, therefore, we reverse and remand this action for a new trial.

In July, 1987, the accounting firm of Ernst & Young (“E & Y”) 2 was hired as an external auditor by Blue Cross and Blue Shield. 3 E & Y was to serve in this capacity during 1987, 1988, and 1989. E & Y’s duties as external auditor included the preparation of audits performed according to “Generally Accepted Accounting Principles.” This type of audit is commonly referred to a GAAP audit.

The provisions of W.Va.Code §§ 33-2-9 (1980) and 33-24-4 (1981) required the West Virginia Commissioner of Insurance “or his accredited examiners” to visit Blue Cross at least every four years and “thoroughly examine its financial condition and methods of doing business”. The Commissioner was authorized by the statutes to appoint personnel who were not his employees to conduct such examinations, presumably as “accredited examiners”. Appointed personnel were to be compensated by the Commissioner, and the insurer being examined was obligated to reimburse the State treasury for such compensation. Shortly after E & Y was hired by Blue Cross, E & Y was contacted by the Insurance Commissioner’s office. The Insur- *123 anee Department was interested in retaining E & Ys services to perform a W.Va.Code § 33-2-9 audit (the statutory audit) of Blue Cross and Blue Shield required for the year 1987, the last such audit of Blue Cross and Blue Shield having been performed in 1983. This type of audit has been, and is, commonly referred to as a “Statutory Accounting Principles” audit or SAP audit. Specific requirements for SAP audits vary from state to state but are controlled in West Virginia by the statutory provisions mentioned above and by Insurance Department regulations.

Hanley Clark, who is the current Insurance Commissioner, was the Deputy Insurance Commissioner at the time the discussions with E & Y were initiated. In the trial below, he testified that the Department decided to obtain an examiner outside the Insurance Department to do the statutory examination, because the Blue Cross system was very complex. He said that Blue Cross was the largest writer of health insurance in West Virginia, and none of the examiners on the Insurance Department’s staff at that time had been the chief examiner in charge of an examination of Blue Cross. Mr. Clark stated that the Insurance Department was interested in engaging E & Y to perform the audit because the Insurance Department was already familiar with E & Y and some of its representatives, having worked with them on another project. In addition, E & Y had been recommended by the Illinois Insurance Department.

Commissioner Clark further testified that the West Virginia Insurance Department was aware that E & Y had already been hired by Blue Cross; however, the Insurance Department wanted a highly qualified accounting firm to handle the examination, and E & Y was the “number one accounting firm in the United States if not the world.” Mr. Clark said at one point that the Insurance Department had difficulty in the past with its examinations being well received by Blue Cross. He said that E & Y was acceptable to Blue Cross, and E & Y was in a position to perform the examination in a more time effective and cost effective manner because of its familiarity with Blue Cross’ finances.

On December 3, 1987, representatives from the Insurance Department, Blue Cross, and E & Y met to discuss the prospect of E & Y conducting the SAP audit. The record indicates that during the meeting there was a discussion regarding whether E & Y would be able to perform an unbiased and independent analysis of Blue Cross’ financial condition, and E & Y made assurances that they would be able to perform an objective audit. Thereafter, E & Y was selected to perform the SAP audit. A letter memorandum dated January 6, 1988, on Ernst and Whinney stationery and addressed to the president of Blue Cross and Blue Shield, discloses the selection of E & Y.

The letter memorandum, introduced below as Plaintiffs Exhibit 13, recites that E & Y had been designated by Blue Cross to “act as independent certified public accountants to examine the financial statements of Blue Cross ... in accordance with generally accepted auditing standards”. The letter then sets forth certain advice “[i]n connection with a request of the West Virginia Department of Insurance to have a statutory examination performed”. Among the points included in that advice by E & Y was that E & Y was independent of Blue Cross and Blue Shield, that they were “aware of the provisions of the insurance statutes and regulations” of West Virginia “related to accounting and financial matters”, that they would conduct the audit in accordance with generally accepted auditing standards and express their opinion “in conformity with accounting practices prescribed or otherwise permitted by the” Insurance Department, that “[i]n performance of this examination” the Insurance Department might “request that we perform additional agreed-upon procedures beyond those which are necessary for expression of an opinion on the financial statements”, and that any “[s]uch procedures would be designed by the Department to accommodate its specific needs in fulfilling the requirements of a statutory examination”. The memorandum advised also that, in the conduct of the examination, Blue Cross and Blue Shield management would be requested to give “written confirmation concerning oral representations made” to E & Y in “connection with the examination” and that the in *124 surer’s “claims forecasting methodology and the resulting impact on rate renewals” would be reviewed. At its end, the letter recited that “[t]his letter is furnished solely for you to comply with the request of the West Virginia Department of Insurance to have a statutory examination” and that the letter did not restrict the authority of the Insurance Commissioner in any manner. The letter concludes with a request to sign and return the letter “to indicate that it is in accordance with your understanding of the arrangements for the scope of our work.” The letter, as introduced into evidence, bears the apparent signature, in script, of “Ernst & Whinney”, and shows “accepted”, with the apparent signature of the president of Blue Cross and Blue Shield, and shows “approved”, with the apparent signature of the Insurance Commissioner, then Fred E. Wright.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Johnston v. CitiFinancial, Inc.
S.D. West Virginia, 2017
Bennett v. Skyline Corp.
52 F. Supp. 3d 796 (N.D. West Virginia, 2014)
Grant Thornton, LLP v. Federal Deposit Insurance
435 F. App'x 188 (Fourth Circuit, 2011)
McRaith v. BDO Seidman, LLP
909 N.E.2d 310 (Appellate Court of Illinois, 2009)
Highmark West Virginia, Inc. v. Jamie
655 S.E.2d 509 (West Virginia Supreme Court, 2007)
Grant Thornton, LLP v. Federal Deposit Insurance
535 F. Supp. 2d 676 (S.D. West Virginia, 2007)
Warfield v. Alaniz
453 F. Supp. 2d 1118 (D. Arizona, 2006)
CHARTER COMMUNICATIONS VI, LLC v. Eleazer
412 F. Supp. 2d 588 (S.D. West Virginia, 2006)
Kidd v. Mull
595 S.E.2d 308 (West Virginia Supreme Court, 2004)
Dailey v. Board of Review, West Virginia Bureau of Employment Programs
589 S.E.2d 797 (West Virginia Supreme Court, 2003)
Poling v. Pre-Paid Legal Services, Inc.
575 S.E.2d 199 (West Virginia Supreme Court, 2002)
Trafalgar House Construction, Inc. v. ZMM, Inc.
567 S.E.2d 294 (West Virginia Supreme Court, 2002)
Sheetz, Inc. v. Bowles Rice McDavid Graff & Love, PLLC
547 S.E.2d 256 (West Virginia Supreme Court, 2001)
State Ex Rel. Rose L. v. Pancake
544 S.E.2d 403 (West Virginia Supreme Court, 2001)
Reider v. Arthur Andersen, LLP
784 A.2d 464 (Connecticut Superior Court, 2001)

Cite This Page — Counsel Stack

Bluebook (online)
483 S.E.2d 248, 199 W. Va. 119, 1996 W. Va. LEXIS 234, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cordial-v-ernst-young-wva-1996.